Surgical data reduces mortality

A study has revealed that since surgeons started publishing data on outcomes for people undergoing heart operations, mortality rates have dropped dramatically.

The Society for Cardiothoracic Surgery studied 400,000 operations performed over the past five years, and found that death rates in coronary artery surgery fell by 21% and in aortic valve replacement operations by one third. This was despite the increasing age of patients and the complexity of their conditions.

Its report, Demonstrating Quality: The Sixth National Audit Cardiac Surgical Database, dismisses concerns that publishing mortality data will lead to surgeons refusing to operate on sicker and older patients, for fear of being seen to have an unexpectedly high death rate.

The Society is now calling on all surgical specialties to be more open about their results in terms of deaths and other outcomes. Its call has been backed by former General Medical Council president, Sir Donald Irvine, who led the inquiry.

Heart surgeons began collecting data after the Bristol ‘heart babies’ scandal, which triggered Britain’s largest ever NHS public inquiry.

Sir Donald said: “I think they took the lesson from Bristol and decided that the kind of recording they were doing really wasn’t any good and they were capable of doing a good deal better. They have come up with very good data which is still in the process of being refined.

“They are now getting to the point where they can look the public in the eye and say we know pretty accurately how individual surgeons perform and whether they are functioning above or below the line.”

The new report, together with data on heartsurgery.cqc.org.uk, published by the Society of Cardiothoracic Surgery and the Care Quality Commission, allows surgeons, heart units and hospitals to benchmark themselves against others to ensure that their work is of the highest possible standard.

John Black, president of the Royal College of Surgeons, said: “This new report proves that open reporting works if well funded and led by the clinicians.

“All branches of surgery are following the trail on reporting outcomes that cardiac surgeons have blazed and this should spur those efforts on. All of medicine should take note of the findings that full audit has not resulted in risk-averse behaviour.”

The society is now looking at data on complications, length of stay, re-admissions and other factors, which provide a more rounded version of the patient experience.

Links: 

Heart surgery in Great Britain

Royal College of Surgeons

Society of Cardiothoracic Surgery

Care Quality Commission